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New diabetes drug approved for NHS in Scotland

A new type 2 diabetes drug is now available to the NHS in Scotland, following a positive recommendation from the Scottish Medicines Consortium.

Canagliflozin (Invokana) is licensed for adults for whom diet and lifestyle measures, or treatment with other glucose-lowering medicines, do not provide adequate control of glucose levels.

The SMC has set certain restrictions on the use of the drug. It can be used as dual therapy in combination with metformin, as triple therapy in combination with metformin plus standard of care, and as an add-on to insulin therapy in combination with insulin plus standard of care.

Canagliflozin is an oral, once-daily tablet, belonging to a drug class called sodium glucose co-transporter 2 (SGLT2) inhibitors, which block the reabsorption of glucose in the kidneys. As a result, the glucose is excreted in urine.

The most common adverse events are genital fungal infections such as thrush, urinary tract infections and increased urination. There is also a low risk of hypoglycaemia associated with canagliflozin treatment when it is used with metformin.